| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 94 === Thanks to advances in medical science with respect to the technology of heart transplantation, patients in Taiwan have shown an increased survival rate. On the other hand, very often patients must nevertheless receive hospitalization for observatory treaments because of a veriety of post-surgical complications. Such facts suggest the subsequent problems of long-term care that still affects patients. An “unanticipated re-hospitalization” rate will better reflect the quality of post-hospitalization care than a mortality rate.
The present study is intended to probe into the rate of unanticipated re-hospitalization of post-surgical heart transplant patients, and the causes and the relevant factors leading to such rates.
A descriptive cross-section design with purposive sampling was used in this study. The study proceeded with structural questionnaires to collect data, including demographic information, disease related questionnaire, drug regimen compliance, symptom distress and management questionnaire, and health-promoting lifestyle profile. A total of 71 patients were recruited in different periods after their heart-transplants.
The major findings of this study show a rate of unanticipated re-hospitalization at 35.2% within one year. Additionally, they show a rate of unanticipated re-hospitalization at 52.2% within five years (inclusive), significantly higher than those over five years at 27.1%. The leading causes to unanticipated re-hospitalizations include infection (31.8%), rejection (25.0%) and cardiac allograft vasculopathy (18.2%). The relevant factors include whether the number of emerging symptoms (t = 2.59, p < 0.05) and the level of symptoms distress (t = 2.71, p < 0.05). The drug regimen compliance and health-promoting lifestyle data show no statistical significance with the unanticipated re-hospitalization. The clinical status, nevertheless, shows the existence of a possible relationship between them.
The findings in the present study might function as a reference to medical professionals on their follow-up care of post-heart-transplant patients. In the future, they will be, in turn, able to provide appropriate medical care toward such patients to maximize the survival rate and rate of unanticipated re-hospitalization.
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